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Chai Y, Man KKC, Luo H, Torre CO, Wing YK, Hayes JF, Osborn DPJ, Chang WC, Lin X, Yin C, Chan EW, Lam ICH, Fortin S, Kern DM, Lee DY, Park RW, Jang JW, Li J, Seager S, Lau WCY, Wong ICK. Incidence of mental health diagnoses during the COVID-19 pandemic: a multinational network study. Epidemiol Psychiatr Sci 2024; 33:e9. [PMID: 38433286 PMCID: PMC10940053 DOI: 10.1017/s2045796024000088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/27/2023] [Accepted: 01/20/2024] [Indexed: 03/05/2024] Open
Abstract
AIMS Population-wide restrictions during the COVID-19 pandemic may create barriers to mental health diagnosis. This study aims to examine changes in the number of incident cases and the incidence rates of mental health diagnoses during the COVID-19 pandemic. METHODS By using electronic health records from France, Germany, Italy, South Korea and the UK and claims data from the US, this study conducted interrupted time-series analyses to compare the monthly incident cases and the incidence of depressive disorders, anxiety disorders, alcohol misuse or dependence, substance misuse or dependence, bipolar disorders, personality disorders and psychoses diagnoses before (January 2017 to February 2020) and after (April 2020 to the latest available date of each database [up to November 2021]) the introduction of COVID-related restrictions. RESULTS A total of 629,712,954 individuals were enrolled across nine databases. Following the introduction of restrictions, an immediate decline was observed in the number of incident cases of all mental health diagnoses in the US (rate ratios (RRs) ranged from 0.005 to 0.677) and in the incidence of all conditions in France, Germany, Italy and the US (RRs ranged from 0.002 to 0.422). In the UK, significant reductions were only observed in common mental illnesses. The number of incident cases and the incidence began to return to or exceed pre-pandemic levels in most countries from mid-2020 through 2021. CONCLUSIONS Healthcare providers should be prepared to deliver service adaptations to mitigate burdens directly or indirectly caused by delays in the diagnosis and treatment of mental health conditions.
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Affiliation(s)
- Yi Chai
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
| | - Kenneth K. C. Man
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong
| | - Hao Luo
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong
| | - Carmen Olga Torre
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Real World Data Sciences, Roche, Welwyn Garden City, UK
- School of Science and Engineering, University of Groningen, Groningen, The Netherlands
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Joseph F. Hayes
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - David P. J. Osborn
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Wing Chung Chang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Xiaoyu Lin
- Real-World Solutions, IQVIA, Durham, NC, USA
| | - Can Yin
- Real-World Solutions, IQVIA, Durham, NC, USA
| | - Esther W. Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong
- The University of Hong Kong Shenzhen Institute of Research and Innovation, Shenzhen, Guangdong, China
| | - Ivan C. H. Lam
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Stephen Fortin
- Observation Health Data Analytics, Janssen Research & Development, Titusville, NJ, USA
| | - David M. Kern
- Department of Epidemiology, Janssen Research & Development, Titusville, NJ, USA
| | - Dong Yun Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Jing Li
- Real-World Solutions, IQVIA, Durham, NC, USA
| | | | - Wallis C. Y. Lau
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong
| | - Ian C. K. Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
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Webb EJD, Kind P, Meads D, Martin A. COVID-19 and EQ-5D-5L health state valuation. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:117-145. [PMID: 36814039 PMCID: PMC9946870 DOI: 10.1007/s10198-023-01569-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND We investigate whether and how general population health state values were influenced by the initial stages of the COVID-19 pandemic. Changes could have important implications, as general population values are used in health resource allocation. DATA In Spring 2020, participants in a UK general population survey rated 2 EQ-5D-5L states, 11111 and 55555, as well as dead, using a visual analogue scale (VAS) from 100 = best imaginable health to 0 = worst imaginable health. Participants answered questions about their pandemic experiences, including COVID-19's effect on their health and quality of life, and their subjective risk/worry about infection. ANALYSIS VAS ratings for 55555 were transformed to the full health = 1, dead = 0 scale. Tobit models were used to analyse VAS responses, as well as multinomial propensity score matching (MNPS) to create samples balanced according to participant characteristics. RESULTS Of 3021 respondents, 2599 were used for analysis. There were statistically significant, but complex associations between experiences of COVID-19 and VAS ratings. For example, in the MNPS analysis, greater subjective risk of infection implied higher VAS ratings for dead, yet worry about infection implied lower ratings. In the Tobit analysis, people whose health was affected by COVID-19 rated 55555 higher, whether the effect on health was positive or negative. CONCLUSION The results complement previous findings that the onset of the COVID-19 pandemic may have impacted EQ-5D-5L health state valuation, and different aspects of the pandemic had different effects.
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Affiliation(s)
- Edward J D Webb
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
| | - Paul Kind
- Institute of Epidemiology and Health, University College London, UK and Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - David Meads
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Adam Martin
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Vardavas C, Zisis K, Nikitara K, Lagou I, Marou V, Aslanoglou K, Athanasakis K, Phalkey R, Leonardi-Bee J, Fernandez E, Condell O, Lamb F, Sandmann F, Pharris A, Deogan C, Suk JE. Cost of the COVID-19 pandemic versus the cost-effectiveness of mitigation strategies in EU/UK/OECD: a systematic review. BMJ Open 2023; 13:e077602. [PMID: 37907290 PMCID: PMC10619092 DOI: 10.1136/bmjopen-2023-077602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/18/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVES The economic burden of COVID-19 pandemic is substantial, with both direct and indirect costs playing a significant role. DESIGN A systematic literature review was conducted to estimate the cost of the COVID-19 pandemic and the cost-effectiveness of pharmaceutical or non-pharmaceutical interventions. All cost data were adjusted to the 2021 Euro, and interventions compared with null. DATA SOURCES Ovid MEDLINE and EMBASE were searched from January 2020 through 22 April 2021. ELIGIBILITY CRITERIA Studies regarding COVID-19 outbreak or public health preparedness measures or interventions with outcome measures related to the direct and indirect costs for disease and preparedness and/or response in countries of the European Union (EU), the European Economic Area (EEA), the UK and the Organisation for Economic Co-operation and Development (OECD) of all relevant epidemiological designs which estimate cost within the selected time frame were considered eligible. DATA EXTRACTION AND SYNTHESIS Studies were searched, screened and coded independently by two reviewers with high measure of inter-rater agreement. Data were extracted to a predefined data extraction sheet. The risk of bias was assessed using the Consensus on Health Economic Criteria checklist. RESULTS We included data from 41 economic studies. Ten studies evaluated the cost of the COVID-19 pandemic, while 31 assessed the cost-benefit of public health surveillance, preparedness and response measures. Overall, the economic burden of the COVID-19 pandemic was found to be substantial. Community screening, bed provision policies, investing in personal-protective-equipment and vaccination strategies were cost-effective. Physical distancing measures were associated with health benefits; however, their cost-effectiveness was dependent on the duration, compliance and the phase of the epidemic in which it was implemented. CONCLUSIONS COVID-19 pandemic is associated with substantial short-term and long-term economic costs to healthcare systems, payers and societies, while interventions including testing and screening policies, vaccination and physical distancing policies were identified as those presenting cost-effective options to deal with the pandemic, dependent on population vaccination and the Re at the stage of the pandemic.
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Affiliation(s)
- Constantine Vardavas
- School of Medicine, University of Crete, Heraklion, Greece
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Konstantinos Zisis
- School of Medicine, University of Crete, Heraklion, Greece
- Department of Public Health Policy, University of West Attica, Egaleo, Greece
| | | | - Ioanna Lagou
- School of Medicine, University of Crete, Heraklion, Greece
| | - Valia Marou
- School of Medicine, University of Crete, Heraklion, Greece
| | | | | | - Revati Phalkey
- Public Health England, London, UK
- University of Nottingham, Nottingham, UK
| | - Jo Leonardi-Bee
- Centre for Evidence-Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Esteve Fernandez
- Tobacco Control Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
| | - Orla Condell
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Favelle Lamb
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Frank Sandmann
- European Centre for Disease Prevention and Control, Solna, Sweden
| | | | - Charlotte Deogan
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control, Solna, Sweden
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Kaur K, Mutanda D, Almond P, Pandey A, Young P, Levitan T, Bibby-Jones AM. A co-produced service evaluation of ethnic minority community service user experiences of a specialist mental health service during the COVID-19 pandemic. BMC Health Serv Res 2023; 23:1107. [PMID: 37848874 PMCID: PMC10583414 DOI: 10.1186/s12913-023-10115-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 10/04/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND For ethnic minority communities in the UK, the COVID-19 pandemic amplified existing health inequalities and created other consequential disadvantages like increased vulnerability to COVID-19, higher rates of hospital admissions, increased mortality and poorer mental health outcomes. While longer-term impacts of COVID-19 are considered, it is crucial for NHS mental health services to understand the specific barriers and needs of ethnic minority communities to provide consistent and equitable access to mental health services. These aspects were the focus of a service evaluation of a Sussex-wide mental health service conducted in co-production with experts-by-experience, public members, health professionals and researchers from ethnic minority communities. METHODS Co-designed creative workshops (n = 13) and semi-structured qualitative interviews (n = 13) were used to explore experiences of accessing specialist mental health services during the COVID-19 pandemic. Participants were: Sussex Partnership NHS Foundation Trust (SPFT) service users recruited between October 2021 and January 2022; aged 16+; from ethnic minority community backgrounds. Data was analysed using Thematic Analysis. RESULTS The analysis yielded five overarching themes contextualising service users' experiences: (1) limited awareness of SPFT mental health services; (2) effects of COVID-19 in gaining access to SPFT; (3) SPFT reaching out to ethnic minorities; (4) being supported, 4a) hiding my mental health status from friends and families, 4b) lack of ethnic diversity in services, and 4c) better provision of information and support services, (5) relationship between childhood experiences and current mental health. These findings led to seven key recommendations for future service developments within SPFT. CONCLUSIONS Although this evaluation was set in the context of COVID-19, findings have highlighted specific mental health service needs for ethnic minorities that are applicable beyond the confines of the pandemic. Many benefited from online sessions seen as more inclusive. Mental health advocates, outreach and joint working with communities could help further reduce stigmatising attitudes and improve engagement with mental health services. Improved service awareness of the impact of childhood or historical traumas experienced by ethnic minority communities on current mental health, the role of cultural awareness training and availability of culturally adapted therapies is also needed. Many service improvement recommendations provided could impact all service users.
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Affiliation(s)
- Kiranpal Kaur
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | | | - Palo Almond
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | | | - Paris Young
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Tony Levitan
- Sussex Partnership NHS Foundation Trust, Worthing, UK
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Naik R, Avula S, Palleti SK, Gummadi J, Ramachandran R, Chandramohan D, Dhillon G, Gill AS, Paiwal K, Shaik B, Balachandran M, Patel B, Gurugubelli S, Mariswamy Arun Kumar AK, Nanjundappa A, Bellamkonda M, Rathi K, Sakhamuri PL, Nassar M, Bali A. From Emergence to Endemicity: A Comprehensive Review of COVID-19. Cureus 2023; 15:e48046. [PMID: 37916248 PMCID: PMC10617653 DOI: 10.7759/cureus.48046] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 11/03/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), later renamed coronavirus disease 2019 (COVID-19), was first identified in Wuhan, China, in early December 2019. Initially, the China office of the World Health Organization was informed of numerous cases of pneumonia of unidentified etiology in Wuhan, Hubei Province at the end of 2019. This would subsequently result in a global pandemic with millions of confirmed cases of COVID-19 and millions of deaths reported to the WHO. We have analyzed most of the data published since the beginning of the pandemic to compile this comprehensive review of SARS-CoV-2. We looked at the core ideas, such as the etiology, epidemiology, pathogenesis, clinical symptoms, diagnostics, histopathologic findings, consequences, therapies, and vaccines. We have also included the long-term effects and myths associated with some therapeutics of COVID-19. This study presents a comprehensive assessment of the SARS-CoV-2 virology, vaccines, medicines, and significant variants identified during the course of the pandemic. Our review article is intended to provide medical practitioners with a better understanding of the fundamental sciences, clinical treatment, and prevention of COVID-19. As of May 2023, this paper contains the most recent data made accessible.
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Affiliation(s)
- Roopa Naik
- Medicine, Geisinger Commonwealth School of Medicine, Scranton, USA
- Internal Medicine/Hospital Medicine, Geisinger Health System, Wilkes Barre, USA
| | - Sreekant Avula
- Diabetes, Endocrinology, and Metabolism, University of Minnesota, Minneapolis, USA
| | - Sujith K Palleti
- Nephrology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Jyotsna Gummadi
- Internal Medicine, MedStar Franklin Square Medical Center, Baltimore, USA
| | | | | | - Gagandeep Dhillon
- Physician Executive MBA, University of Tennessee, Knoxville, USA
- Internal Medicine, University of Maryland Baltimore Washington Medical Center, Glen Burnie, USA
| | | | - Kapil Paiwal
- Oral & Maxillofacial Pathology, Daswani Dental College & Research Center, Kota, IND
| | - Bushra Shaik
- Internal Medicine, Onslow Memorial Hospital, Jacksonville, USA
| | | | - Bhumika Patel
- Oral Medicine and Radiology, Howard University, Washington, D.C., USA
| | | | | | | | - Mahita Bellamkonda
- Hospital Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Kanika Rathi
- Internal Medicine, University of Florida, Gainesville, USA
| | | | - Mahmoud Nassar
- Endocrinology, Diabetes, and Metabolism, Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA
| | - Atul Bali
- Internal Medicine/Nephrology, Geisinger Medical Center, Danville, USA
- Internal Medicine/Nephrology, Geisinger Health System, Wilkes-Barre, USA
- Medicine, Geisinger Commonwealth School of Medicine, Scranton, USA
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Ambade PN, Thavorn K, Pakhale S. COVID-19 Pandemic: Did Strict Mobility Restrictions Save Lives and Healthcare Costs in Maharashtra, India? Healthcare (Basel) 2023; 11:2112. [PMID: 37510552 PMCID: PMC10379405 DOI: 10.3390/healthcare11142112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/29/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown's impact on COVID-19 cases and associated healthcare costs. METHODS Using daily case data for 84 days (9 March-31 May 2020), we modeled the epidemic's trajectory and predicted new cases for different phases of lockdown. We fitted log-linear models to estimate the growth rate, basic (R0), daily reproduction number (Re), and case doubling time. Based on pre-restriction and Phase 1 R0, we predicted new cases for the rest of the restriction phases, and we compared them with the actual number of cases during each phase. Furthermore, using the published and gray literature, we estimated the costs and savings of implementing these restrictions for the projected period, and we performed a sensitivity analysis. RESULTS The estimated median R0 during the different phases was 1.14 (95% CI: 0.85, 1.45) for pre-lockdown, 1.67 (95% CI: 1.50, 1.82) for phase 1 (strict mobility restrictions), 1.24 (95% CI: 1.12, 1.35) for phase 2 (extension of phase 1 with no restrictions on agricultural and essential services), 1.12 (95% CI: 1.01, 1.23) for phase 3 (extension of phase 2 with mobility relaxations in areas with few infections), and 1.05 (95% CI: 0.99, 1.123) for phase 4 (implementation of localized lockdowns in high-case-load areas with fewer restrictions on other areas), respectively. The corresponding doubling time rate for cases (in days) was 17.78 (95% CI: 5.61, -15.19), 3.87 (95% CI: 3.15, 5.00), 10.37 (95% CI: 7.10, 19.30), 20.31 (95% CI: 10.70, 212.50), and 45.56 (95% CI: 20.50, -204.52). For the projected period, the cases could have reached 631,819 without the lockdown, as the actual reported number of cases was 64,975. From a healthcare perspective, the estimated total value of averted cases was INR 194.73 billion (USD 2.60 billion), resulting in net cost savings of 84.05%. The Incremental Cost-Effectiveness Ratio (ICER) per Quality Adjusted Life Year (QALY) for implementing the lockdown, rather than observing the natural course of the pandemic, was INR 33,812.15 (USD 450.83). CONCLUSION Maharashtra's early public health response delayed the pandemic and averted new cases and deaths during the first wave of the pandemic. However, we recommend that such restrictions be carefully used while considering the local socio-economic realities in countries like India.
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Affiliation(s)
- Preshit Nemdas Ambade
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Kednapa Thavorn
- Faculty of Medicine, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Smita Pakhale
- Faculty of Medicine, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
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Gomes JJF, Ferreira A, Alves A, Sequeira BN. A risk scoring model of COVID-19 at hospital admission. PLoS One 2023; 18:e0288460. [PMID: 37471332 PMCID: PMC10358923 DOI: 10.1371/journal.pone.0288460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/21/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has been the most serious public health crisis in recent times, a pandemic whose impact was felt across the globe in various groups and populations. Confronted with an urgent problem, people and governments were forced to make decisions without fully understanding the disease. The present work aims to reinforce our ever-growing knowledge of the illness, particularly in modelling the risk of death of a patient admitted to a hospital with a positive COVID-19 test. METHODS Given the simplicity of using and programming logistic regression in any national healthcare unit and the ease of interpreting the results, we chose to use this technique over several other. Using scoring techniques, it is possible to associate the various diagnoses with a numerical value (score), making it possible therefore to integrate the patient's multiple medical conditions as a single continuous variable in the model. RESULTS It is possible to establish with good discriminatory capacity (ROC AUC Test = 0.8) which COVID patients are at higher risk when admitted to the healthcare unit-people of advanced age with pre-existing conditions, such as diabetes and high blood pressure, or newly acquired conditions, such as pneumonia. Moreover, males and clinical episodes occurring in healthcare units with few available beds (high healthcare unit occupancy) are also at higher risk. The importance of each variable in predicting the target is: age (47%), sum of comorbidity scores (28%), healthcare unit score (12.0%), gender score (7%) and healthcare unit occupancy (6%). CONCLUSIONS Using a dataset with more than 52000 people, it was possible to successfully differentiate likelihood of death by COVID using age, comorbidity information, healthcare unit, healthcare unit occupancy and gender. The age and the comorbidities associated with each patient had a joint contribution of about 75% in explaining the COVID related mortality in Portuguese public hospitals in the period between March 2020 and May 2021.
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Affiliation(s)
| | - António Ferreira
- Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Afonso Alves
- Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
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Butterworth J, Smerdon D, Baumeister R, von Hippel W. Cooperation in the Time of COVID. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023:17456916231178719. [PMID: 37384624 DOI: 10.1177/17456916231178719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Humans evolved to be hyper-cooperative, particularly when among people who are well known to them, when relationships involve reciprocal helping opportunities, and when the costs to the helper are substantially less than the benefits to the recipient. Because humans' cooperative nature evolved over many millennia when they lived exclusively in small groups, factors that cause cooperation to break down tend to be those associated with life in large, impersonal, modern societies: when people are not identifiable, when interactions are one-off, when self-interest is not tied to the interests of others, and when people are concerned that others might free ride. From this perspective, it becomes clear that policies for managing pandemics will be most effective when they highlight superordinate goals and connect people or institutions to one another over multiple identifiable interactions. When forging such connections is not possible, policies should mimic critical components of ancestral conditions by providing reputational markers for cooperators and reducing the systemic damage caused by free riding. In this article, we review policies implemented during the pandemic, highlighting spontaneous community efforts that leveraged these aspects of people's evolved psychology, and consider implications for future decision makers.
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Kabir KA. Impact of human cooperation on vaccination behaviors. Heliyon 2023; 9:e16748. [PMID: 37292270 PMCID: PMC10245234 DOI: 10.1016/j.heliyon.2023.e16748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/10/2023] Open
Abstract
This paper studies a dynamic vaccination game model embedded with vaccine cost-effectiveness and dyadic game during an epidemic, assuming the appearance of cooperation among individuals from an evolutionary perspective. The infection dynamics of the individuals' states follow a modified S/VIS (susceptible/vaccinated-infected-susceptible) dynamics. Initially, we assume that the individuals are unsure about their infection status. Thus, they make decisions regarding their options based on their neighbors' perceptions, the prevalence of the disease, and the characteristics of the available vaccines. We then consider the strategy updating process IBRA (individuals-based risk assessment) concerning an individual's committing vaccination based on a neighbor's decision. In the perspective of social dilemma, it presents the idea of social efficiency deficit to find the gap between social optimum and Nash equilibrium point based on dilemma strength by considering vaccine decision. The cost and cooperative behavior depend on disease severity, neighbor's attitude, and vaccine properties to obtain a reduced-order optimal solution to control infectious diseases. Vaccine factors (efficiency, cost, and benefit) are crucial in changing human vaccine decisions and cooperative behavior. It turns out that, even in the prisoner's dilemma case, where all defection attitude occurs, vaccine uptake (cooperation) increases. Finally, extensive numerical studies were presented that illustrate interesting phenomena and investigate the ultimate extent of the epidemic, vaccination coverage, average social benefits, and the social efficiency deficit concerning optimal strategies and the dynamic vaccine attitudes of individuals. PACS numbers. Theory and modeling; computer simulation, 87.15. Aa; Dynamics of evolution, 87.23. Kg.
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Antioch KM. The economics of the COVID-19 pandemic: economic evaluation of government mitigation and suppression policies, health system innovations, and models of care. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-16. [PMID: 37361278 PMCID: PMC10206578 DOI: 10.1007/s10389-023-01919-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/20/2023] [Indexed: 06/28/2023]
Abstract
Background The COVID-19 pandemic has impacted the scope of health economics literature, which will increasingly examine value beyond health care interventions such as government policy and broad health system innovations. Aim The study analyzes economic evaluations and methodologies evaluating government policies suppressing or mitigating transmission and reducing COVID-19, broad health system innovations, and models of care. This can facilitate future economic evaluations and assist government and public health policy decisions during pandemics. Methods The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used. Methodological quality was quantified using the scoring criteria in European Journal of Health Economics, Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 Checklist and the National Institute for Health and Care Excellence's (NICE) Cost Benefit Analysis Checklist. PUBMED, Medline, and Google Scholar were searched from 2020-2021. Results Cost utility analysis (CUA) and cost benefit analysis (CBA) analyzing mortality, morbidity, quality adjusted life year (QALY) gained, national income loss, and value of production effectively evaluate government policies suppressing or mitigating COVID-19 transmission, disease, and impacting national income loss. The WHO's pandemic economic framework facilitates economic evaluations of social and movement restrictions. Social return on investment (SROI) links benefits to health and broader social improvements. Multi-criteria decision analysis (MCDA) can facilitate vaccine prioritization, equitable health access, and technology evaluation. Social welfare function (SWF) can account for social inequalities and population-wide policy impact. It is a generalization of CBA, and operationally, it is equal to an equity-weighted CBA. It can provide governments with a guideline for achieving the optimal distribution of income, which is vital during pandemics. Economic evaluations of broad health system innovations and care models addressing COVID-19 effectively use cost effectiveness analysis (CEA) that utilize decision trees and Monte Carlo models, and CUAs that effectively utilize decision trees and Markov models, respectively. Conclusion These methodologies are very instructive for governments, in addition to their current use of CBA and the value of a statistical life analytical tool. CUA and CBA effectively evaluate government policies suppressing or mitigating COVID-19 transmission, disease, and impacts on national income loss. CEA and CUA effectively evaluate broad health system innovations and care models addressing COVID-19. The WHO's framework, SROI, MCDA, and SWF can also facilitate government decision-making during pandemics. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-023-01919-z.
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Affiliation(s)
- Kathryn Margaret Antioch
- Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria Australia
- Guidelines and Economists Network International (GENI), 27 Monaro Road, Kooyong, Melbourne, VIC 3144 Australia
- Health Economics and Funding Reforms, Melbourne, Victoria Australia
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11
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Izadi R, Hatam N, Baberi F, Yousefzadeh S, Jafari A. Economic evaluation of strategies against coronavirus: a systematic review. HEALTH ECONOMICS REVIEW 2023; 13:18. [PMID: 36933043 PMCID: PMC10024293 DOI: 10.1186/s13561-023-00430-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/10/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND The COVID-19 outbreak was defined as a pandemic on 11 March 2020 by the World Health Organization. After that, COVID-19 has enormously influenced health systems around the world, and it has claimed more than 4.2 million deaths until July 2021. The pandemic has led to global health, social and economic costs. This situation has prompted a crucial search for beneficial interventions and treatments, but little is known about their monetary value. This study is aimed at systematically reviewing the articles conducted on the economic evaluation of preventive, control and treatment strategies against COVID-19. MATERIAL AND METHOD We searched PubMed, Web of Science, Scopus, and Google Scholar from December 2019 to October 2021 to find applicable literature to the economic evaluation of strategies against COVID-19. Two researchers screened potentially eligible titles and abstracts. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to quality assessment of studies. RESULTS Thirty-six studies were included in this review, and the average CHEERS score was 72. Cost-effectiveness analysis was the most common type of economic evaluation, used in 21 studies. And the quality-adjusted life year (QALY) was the main outcome applied to measure the effectiveness of interventions, which was used in 19 studies. In addition, articles were reported a wide range of incremental cost-effectiveness ratio (ICER), and the lowest cost per QALY ($321.14) was related to the use of vaccines. CONCLUSION Based on the results of this systematic review, it seems that all strategies are likely to be more cost-effective against COVID-19 than no intervention and vaccination was the most cost-effective strategy. This research provides insight for decision makers in choosing optimal interventions against the next waves of the current pandemic and possible future pandemics.
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Affiliation(s)
- Reyhane Izadi
- Department of Health Care Management, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahid Hatam
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Baberi
- Deputy of Research and Technology, School of Medicine, Shiraz University of Medical, Sciences, Shiraz, Iran
| | - Setareh Yousefzadeh
- Social Determinants of Health Research Center, Health Research Institute, Babol, University of Medical Sciences, Babol, Iran
| | - Abdosaleh Jafari
- Health Human Resources Research Centre, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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12
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Mo PKH, Yu Y, Lau MMC, Ling RHY, Lau JTF. Time to Lift up COVID-19 Restrictions? Public Support towards Living with the Virus Policy and Associated Factors among Hong Kong General Public. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2989. [PMID: 36833683 PMCID: PMC9958650 DOI: 10.3390/ijerph20042989] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
The fifth wave of the COVID-19 pandemic has caused an unprecedented toll on Hong Kong. As more countries are starting to lift COVID-19 restrictions, it would be important to understand the public attitudes towards lifting COVID-19 restrictions and to identify its associated factors. The present study examined the level of support towards the living with the virus (LWV) policy for COVID-19 among the public in Hong Kong and to identify the associations between resilient coping, self-efficacy and emotional distress with support towards the LWV policy. A random population-based telephone survey was conducted among 500 Hong Kong Chinese adults from 7 March to 19 April 2022, i.e., during the fifth wave of COVID-19 outbreak. Of the respondents, 39.6% showed a supportive attitude towards the LWV policy. Results from the structural equational modeling showed a positive correlation between resilient coping and self-efficacy. Resilient coping was associated with support towards the LWV policy directly and indirectly through a lower level of emotional distress. Self-efficacy had a direct association with support towards the LWV policy but its indirect association through emotional distress was not significant. Interventions that foster resilient coping and self-efficacy would be effective in reducing public emotional distress and promoting their positive view towards the LWV policy.
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Affiliation(s)
- Phoenix K. H. Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yanqiu Yu
- School of Public Health, Fudan University, Shanghai 200030, China
| | - Mason M. C. Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Rachel H. Y. Ling
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joseph T. F. Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, China
- School of Mental Health, Wenzhou Medical University, Wenzhou 325000, China
- School of Public Health, Zhejiang University, Hangzhou 311100, China
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Șoitu CT, Grecu SP, Asiminei R. Health Security, Quality of Life and Democracy during the COVID-19 Pandemic: Comparative Approach in the EU-27 Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14436. [PMID: 36361316 PMCID: PMC9654764 DOI: 10.3390/ijerph192114436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
The aim of this paper is to emphasize the role played by the social, economic and political variables in shaping models of sustainable healthcare systems and strategies able to support and improve the quality of life during and after the COVID-19 pandemic. The context of our research is represented by the medical and socioeconomic crises generated by the COVID-19 pandemic. The current pandemic negatively affects healthcare systems, quality of life and the global economy. In this respect, this paper aims to thoroughly scrutinize the effects of the COVID-19 pandemic on the social and healthcare systems of EU countries, to analyze the impact of human development in the field of the Global Health Security Index and to estimate the relation between resilience and quality of life during the COVID-19 pandemic. The research design is quantitative, resorting to the use of both descriptive and inferential statistics, against the background of a long-term comparative approach to the respective situations in the EU-27 countries. Empirical findings are relevant for emphasizing the fact that human development and social progress are predictors for the dynamics of health security measures. Moreover, the quality of the political regime, particularly in the case of full and flawed democracies, is strongly related to a high level of resilience and could influence the perception of quality of life. All of these empirical results could prove valuable for scholars interested in understanding the relationships between democracy, healthcare systems and quality of life, and for political decision makers involved in the effort of reducing the negative effects of COVID-19 in EU-27 countries.
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Affiliation(s)
- Conțiu Tiberiu Șoitu
- Department of Sociology and Social Work, “Alexandru Ioan Cuza” University of Iași, 700506 Iași, Romania
| | - Silviu-Petru Grecu
- Department of Political Sciences, International Relations and European Studies, “Alexandru Ioan Cuza” University of Iași, 700506 Iași, Romania
| | - Romeo Asiminei
- Department of Sociology and Social Work, “Alexandru Ioan Cuza” University of Iași, 700506 Iași, Romania
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Mintram K, Anagnostou A, Anokye N, Okine E, Groen D, Saha A, Abubakar N, Islam T, Daroge H, Ghorbani M, Xue Y, Taylor SJE. CALMS: Modelling the long-term health and economic impact of Covid-19 using agent-based simulation. PLoS One 2022; 17:e0272664. [PMID: 36037156 PMCID: PMC9423607 DOI: 10.1371/journal.pone.0272664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/24/2022] [Indexed: 11/18/2022] Open
Abstract
We present our agent-based CoronAvirus Lifelong Modelling and Simulation (CALMS) model that aspires to predict the lifelong impacts of Covid-19 on the health and economy of a population. CALMS considers individual characteristics as well as comorbidities in calculating the risk of infection and severe disease. We conduct two sets of experiments aiming at demonstrating the validity and capabilities of CALMS. We run simulations retrospectively and validate the model outputs against hospitalisations, ICU admissions and fatalities in a UK population for the period between March and September 2020. We then run simulations for the lifetime of the cohort applying a variety of targeted intervention strategies and compare their effectiveness against the baseline scenario where no intervention is applied. Four scenarios are simulated with targeted vaccination programmes and periodic lockdowns. Vaccinations are targeted first at individuals based on their age and second at vulnerable individuals based on their health status. Periodic lockdowns, triggered by hospitalisations, are tested with and without vaccination programme in place. Our results demonstrate that periodic lockdowns achieve reductions in hospitalisations, ICU admissions and fatalities of 6-8% compared to the baseline scenario, with an associated intervention cost of £173 million per 1,000 people and targeted vaccination programmes achieve reductions in hospitalisations, ICU admissions and fatalities of 89-90%, compared to the baseline scenario, with an associated intervention cost of £51,924 per 1,000 people. We conclude that periodic lockdowns alone are ineffective at reducing health-related outputs over the long-term and that vaccination programmes which target only the clinically vulnerable are sufficient in providing healthcare protection for the population as a whole.
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Affiliation(s)
- Kate Mintram
- Modelling and Simulation Group, Department of Computer Science, Brunel University London, Uxbridge, London, United Kingdom
- * E-mail: (KM); (AA)
| | - Anastasia Anagnostou
- Modelling and Simulation Group, Department of Computer Science, Brunel University London, Uxbridge, London, United Kingdom
- * E-mail: (KM); (AA)
| | - Nana Anokye
- Global Public Health, Department of Health Sciences, Brunel University London, Uxbridge, London, United Kingdom
| | - Edward Okine
- Global Public Health, Department of Health Sciences, Brunel University London, Uxbridge, London, United Kingdom
| | - Derek Groen
- Modelling and Simulation Group, Department of Computer Science, Brunel University London, Uxbridge, London, United Kingdom
| | - Arindam Saha
- Modelling and Simulation Group, Department of Computer Science, Brunel University London, Uxbridge, London, United Kingdom
| | - Nura Abubakar
- Modelling and Simulation Group, Department of Computer Science, Brunel University London, Uxbridge, London, United Kingdom
| | - Tasin Islam
- Modelling and Simulation Group, Department of Computer Science, Brunel University London, Uxbridge, London, United Kingdom
| | - Habiba Daroge
- Modelling and Simulation Group, Department of Computer Science, Brunel University London, Uxbridge, London, United Kingdom
| | - Maziar Ghorbani
- Department of Electronic and Computer Engineering, Brunel University London, Uxbridge, London, United Kingdom
| | - Yani Xue
- Modelling and Simulation Group, Department of Computer Science, Brunel University London, Uxbridge, London, United Kingdom
| | - Simon J. E. Taylor
- Modelling and Simulation Group, Department of Computer Science, Brunel University London, Uxbridge, London, United Kingdom
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15
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Vaccinations versus Lockdowns to Prevent COVID-19 Mortality. Vaccines (Basel) 2022; 10:vaccines10081347. [PMID: 36016236 PMCID: PMC9413824 DOI: 10.3390/vaccines10081347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/31/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Measures employed to combat COVID-19 included public lockdowns and vaccination campaigns. Israel’s extensive public health system produced data demonstrating the real-world results of these measures. Our objective was to evaluate the health and economic outcomes of the measures to cope with COVID-19. Publicly available datasets from the Israeli Ministry of Health were used to model the parameters of the pandemic in Israel. The Oxford COVID-19 Government Response Tracker was used for quantitative data on government policies. Data on the Israeli economy were taken from the Central Bureau of Statistics. Our models demonstrate that the first lockdown prevented 1022 COVID-19 deaths at the cost of 36.4–38.6 billion NIS. The second lockdown prevented 1970 COVID-19 deaths and cost 18–21 billion NIS. These lifesaving effects were observed with a time lag from the declaration of lockdown. The primary vaccination campaign cost 1 billion NIS and prevented 4750 COVID-19 deaths. The first vaccination booster campaign prevented 650 COVID-19 deaths and cost 51.1 million NIS. Therefore, the cost per prevented COVID-19 death is 10–36 million NIS with a national lockdown versus 210,000 NIS in the primary vaccination campaign and 79,000 NIS in the first booster campaign. In conclusion, both lockdowns and vaccination campaigns effectively lower COVID-19 deaths, but the cost to avoid one COVID-19 death with effective vaccination is 50–466 times lower than with a lockdown.
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16
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Rasmussen MK, Kronborg C, Fasterholdt I, Kidholm K. Economic evaluations of interventions against viral pandemics: a scoping review. Public Health 2022; 208:72-79. [PMID: 35724446 PMCID: PMC9212686 DOI: 10.1016/j.puhe.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/04/2022] [Indexed: 11/28/2022]
Abstract
Objectives The COVID-19 pandemic has led to suggestions that cost-effectiveness analyses should adopt a broader perspective when estimating costs. This review aims to provide an overview of economic evaluations of interventions against viral pandemics in terms of the perspective taken, types of costs included, comparators, type of economic model, data sources and methods for estimating productivity costs. Study design Scoping literature review. Methods Publications were eligible if they conducted a cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis or cost-minimisation analysis and evaluated interventions aimed at viral pandemics or for patients infected with viral pandemic disease. We searched PubMed, Embase and Scopus for relevant references and charted data from the selected full-text publications into a predefined spreadsheet based on research sub-questions, summary tables and figures. Results From 5410 references, 36 full-text publications fulfilled the inclusion criteria. The economic evaluations were mainly model based and included direct medical costs of hospital treatment. Around half of the studies included productivity costs and the proportion of total costs attributed to productivity costs ranged from 10% to 90%, depending on estimation methods, assumptions about valuation of time, type of intervention, severity of illness and degree of transmission. Conclusions Economic evaluations of interventions against viral pandemics differed in terms of estimation methods and reporting of productivity costs, even for similar interventions. Hence, the literature on economic evaluations for pandemic response would benefit from having standards for conducting and reporting economic evaluations, especially for productivity costs.
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Affiliation(s)
- M K Rasmussen
- Centre for Innovative Medical Technology, Odense University Hospital, And Department of Clinical Research, University of Southern Denmark, Denmark.
| | - C Kronborg
- Department of Economics, University of Southern Denmark, Denmark
| | - I Fasterholdt
- Centre for Innovative Medical Technology, Odense University Hospital, And Department of Clinical Research, University of Southern Denmark, Denmark
| | - K Kidholm
- Centre for Innovative Medical Technology, Odense University Hospital, And Department of Clinical Research, University of Southern Denmark, Denmark
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Zhou L, Yan W, Li S, Yang H, Zhang X, Lu W, Liu J, Wang Y. Cost-effectiveness of interventions for the prevention and control of COVID-19: Systematic review of 85 modelling studies. J Glob Health 2022; 12:05022. [PMID: 35712857 PMCID: PMC9196831 DOI: 10.7189/jogh.12.05022] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background We aimed to quantitatively summarise the health economic evaluation evidence of prevention and control programs addressing COVID-19 globally. Methods We did a systematic review and meta-analysis to assess the economic and health benefit of interventions for COVID-19. We searched PubMed, Embase, Web of Science, and Cochrane Library of economic evaluation from December 31, 2019, to March 22, 2022, to identify relevant literature. Meta-analyses were done using random-effects models to estimate pooled incremental net benefit (INB). Heterogeneity was assessed using I2 statistics and publication bias was assessed by Egger's test. This study is registered with PROSPERO, CRD42021267475. Results Of 16 860 studies identified, 85 articles were included in the systematic review, and 25 articles (10 studies about non-pharmacological interventions (NPIs), five studies about vaccinations and 10 studies about treatments) were included in the meta-analysis. The pooled INB of NPIs, vaccinations, and treatments were $1378.10 (95% CI = $1079.62, $1676.59), $254.80 (95% CI = $169.84, $339.77) and $4115.11 (95% CI = $1631.09, $6599.14), respectively. Sensitivity analyses showed similar findings. Conclusions NPIs, vaccinations, and treatments are all cost-effective in combating the COVID-19 pandemic. However, evidence was mostly from high-income and middle-income countries. Further studies from lower-income countries are needed.
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Affiliation(s)
- Lihui Zhou
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenxin Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Shu Li
- School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hongxi Yang
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Xinyu Zhang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenli Lu
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
- Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Zhang Z, Liu C, Nunkoo R, Sunnassee VA, Chen X. Rethinking Lockdown Policies in the Pre-Vaccine Era of COVID-19: A Configurational Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127142. [PMID: 35742409 PMCID: PMC9223109 DOI: 10.3390/ijerph19127142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/04/2022] [Accepted: 06/08/2022] [Indexed: 12/10/2022]
Abstract
The significance of lockdown policies for controlling the COVID-19 pandemic is widely recognized. However, most studies have focused on individual lockdown measures. The effectiveness of lockdown policy combinations has not been examined from a configurational perspective. This research applies fuzzy-set qualitative comparative analysis (fsQCA) to examine different lockdown policy combinations associated with high-epidemic situations in 84 countries. A high-epidemic situation can occur through three different “weak-confined” patterns of lockdown policy combinations. The findings demonstrate that a combination of lockdown policies is more successful than any single lockdown policy, whereas the absence of several key measures in policy combinations can lead to a high-epidemic situation. The importance of international travel controls can become obscured when they are the only measures adopted, and a high-epidemic situation can still arise where restrictions are placed on international travel but not on public transport or when workplaces are closed but schools remain open.
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Affiliation(s)
- Ziang Zhang
- School of Geography, Nanjing Normal University, Nanjing 210023, China;
| | - Chao Liu
- Faculty of Hospitality & Tourism Management, Macau University of Science and Technology, Taipa, Macau 999078, China
- Correspondence:
| | - Robin Nunkoo
- Department of Management, University of Mauritius, Reduit MU 80837, Mauritius;
- School of Tourism and Hospitality, University of Johannesburg, P.O. Box 524, Auckland Park 2006, South Africa
- Griffith Institute for Tourism, Griffith University, Gold Coast, QLD 4222, Australia
- Copenhagen Business School, Porcelaenshaven 18A, DK-2000 Frederiksberg, Denmark
| | - Vivek A. Sunnassee
- Westminster Business School, University of Westminster, 35 Marylebone Road, London NW1 5LS, UK;
| | - Xiaoyan Chen
- School of Humanities, Jiangsu University of Technology, Changzhou 213001, China;
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Xia CL, Wei AP, Huang YT. The COVID-19 Lockdown and Mental Wellbeing of Females in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094960. [PMID: 35564365 PMCID: PMC9100609 DOI: 10.3390/ijerph19094960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/27/2022] [Accepted: 04/08/2022] [Indexed: 02/06/2023]
Abstract
Most studies consider that COVID-19 lockdowns lead to mental health problems for females, while the effect of role change on female mental health has been overlooked. This study aimed to explore multiple facets of the risk of mental distress in a sample of Chinese married females aged 21-50 during the COVID-19 lockdowns. A cross-sectional study was carried out with 613 valid responses from married females in the Guangdong province. Our primary tool was a questionnaire using a Kessler-10 scale to detect the probability of mental distress based on the level of nervousness, tiredness, restlessness, and depression. Eighty-eight point three percent of married females possessed a high risk of psychological distress because they frequently felt tired out, hopeless, and restless. The evidence suggests that the lockdown has caused a conflict in the female role to maintain a balance between family and career. Increasing family care responsibilities are positively associated with nervousness, tiredness, and mental disorder. The heterogeneity of the social role in mental wellbeing is explored. Married females whose income was worse off during the lockdown are negatively associated with mental wellbeing. Married females who are employed are found to be less mentally healthy than the self-employed.
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Affiliation(s)
- Chang-Lan Xia
- Faculty of Business, City University of Macau, Macau 999078, China;
| | - An-Pin Wei
- Department of Business Management, National Taichung University of Science and Technology, No. 129, Sec. 3, Sanmin Rd., North Dist., Taichung 404336, Taiwan
- Correspondence:
| | - Yu-Ting Huang
- Bachelor Program of International Management, National Yunlin University of Science and Technology, Yunlin 640301, Taiwan;
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McBride O, Bunting E, Harkin O, Butter S, Shevlin M, Murphy J, Mason L, Hartman TK, McKay R, Hyland P, Levita L, Bennett KM, Stocks TVA, Gibson-Miller J, Martinez AP, Vallières F, Bentall RP. Testing both affordability-availability and psychological-coping mechanisms underlying changes in alcohol use during the COVID-19 pandemic. PLoS One 2022; 17:e0265145. [PMID: 35324964 PMCID: PMC8947385 DOI: 10.1371/journal.pone.0265145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/23/2022] [Indexed: 11/26/2022] Open
Abstract
Two theoretical perspectives have been proffered to explain changes in alcohol use during the pandemic: the ‘affordability-availability’ mechanism (i.e., drinking decreases due to changes in physical availability and/or reduced disposable income) and the ‘psychological-coping’ mechanism (i.e., drinking increases as adults attempt to cope with pandemic-related distress). We tested these alternative perspectives via longitudinal analyses of the COVID-19 Psychological Consortium (C19PRC) Study data (spanning three timepoints during March to July 2020). Respondents provided data on psychological measures (e.g., anxiety, depression, posttraumatic stress, paranoia, extraversion, neuroticism, death anxiety, COVID-19 anxiety, intolerance of uncertainty, resilience), changes in socio-economic circumstances (e.g., income loss, reduced working hours), drinking motives, solitary drinking, and ‘at-risk’ drinking (assessed using a modified version of the AUDIT-C). Structural equation modelling was used to determine (i) whether ‘at-risk’ drinking during the pandemic differed from that recalled before the pandemic, (ii) dimensions of drinking motives and the psychosocial correlates of these dimensions, (iii) if increased alcohol consumption was predicted by drinking motives, solitary drinking, and socio-economic changes. The proportion of adults who recalled engaging in ‘at-risk’ drinking decreased significantly from 35.9% pre-pandemic to 32.0% during the pandemic. Drinking to cope was uniquely predicted by experiences of anxiety and/or depression and low resilience levels. Income loss or reduced working hours were not associated with coping, social enhancement, or conformity drinking motives, nor changes in drinking during lockdown. In the earliest stage of the pandemic, psychological-coping mechanisms may have been a stronger driver to changes in adults’ alcohol use than ‘affordability-availability’ alone.
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Affiliation(s)
- Orla McBride
- Ulster University, Coleraine, Northern Ireland
- * E-mail:
| | | | | | - Sarah Butter
- Ulster University, Coleraine, Northern Ireland
- University of Sheffield, Sheffield, England
| | | | | | - Liam Mason
- University College London, London, England
| | | | - Ryan McKay
- Royal Holloway, University of London, Egham, England
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Evidence from Thailand on Easing COVID-19’s International Travel Restrictions: An Impact on Economic Production, Household Income, and Sustainable Tourism Development. SUSTAINABILITY 2022. [DOI: 10.3390/su14063423] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Even though international travel restrictions are being used to keep the COVID-19 pandemic under control, these measures cannot be considered as long-term solutions to the ongoing crisis. Limitations on traveling activities have tremendous adverse consequences on a country’s economy, particularly leading in radically expanding economic downturn and a shrinking tourism industry. To overcome this hardship, several countries have eased COVID-19 travel restrictions. However, there are still questions concerning the benefit to society as the impact assessment of this implementation transmitting to an economy has not been explicitly investigated. In response to this, we aim to assess the impacts of this implementation as to provide a guideline to global countries for their future adoption. By calculating the output and household income multipliers from the tourism input–output table, this study utilizes a case study from Thailand to indicate that prolonging the full mobility restrictions of international tourists, which results in a yearly loss of revenue in Thai tourism industry, would cost country production up to 144.97 billion USD and up to 45.4 billion USD for loss of household income. When international travel limitations were relaxed, production and household damage would fall to 142.24 billion USD (+1.88%) and 44.7 billion USD (+1.54%), respectively. At individual sectors level, our calculation identified that the most damage of production activities would exist in public utility, agriculture, and food manufacturing sectors. In the perspective of household income, those in the agricultural sector would have greatest impact. This impact results from the Thai tourism industry positioned as a buyer in an economy, having most impact on sectors selling their products or inputs to the tourism industry. As suggested by the input–output multipliers, we emphasize that strengthening the resilience of tourism-related sectors and reforming the tourism industry in relation to potential consumption and production patterns are critical for sustainable tourism development.
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Mental Health and Wellbeing in Young People in the UK during Lockdown (COVID-19). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031132. [PMID: 35162165 PMCID: PMC8834421 DOI: 10.3390/ijerph19031132] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 12/11/2022]
Abstract
This study aimed to assess the levels of mental wellbeing and potential for clinical need in a sample of UK university students aged 18–25 during the COVID-19 pandemic. We also tested the dose-response relationship between the severity of lockdown restrictions and mental wellbeing. We carried out a prospective shortitudinal study (one month between baseline and follow up) during the pandemic to do this and included 389 young people. We measured a range of facets of mental wellbeing, including depression, depressogenic cognition (rumination), wellbeing, stress and sleep disturbance. Our primary outcome was ‘probable depression’ as indexed by a score of ≥10 on the patient health questionnaire (PHQ-8). The prevalence of probable depression was significantly higher than pre-pandemic levels (55%) and did not decrease significantly over time (52%). Higher levels of lockdown severity were prospectively associated with higher levels of depressive symptoms. Nearly all students had at least one mental wellbeing concern at either time point (97%). The evidence suggests that lockdown has caused a wellbeing crisis in young people. The associated long-term mental, social, educational, personal and societal costs are as yet unknown but should be tracked using further longitudinal studies.
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Wang F, Wang JD. Estimating US Earnings Loss Associated with COVID-19 Based on Human Capital Calculation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1015. [PMID: 35055834 PMCID: PMC8775690 DOI: 10.3390/ijerph19021015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/09/2022] [Accepted: 01/15/2022] [Indexed: 12/30/2022]
Abstract
Infection with COVID-19 could result in lockdown, quarantine of contacts, absenteeism from work, and temporary productivity loss. This research aims to calculate (1) how the pandemic affects on-the-job probability and earnings for the working population, and (2) how much productivity loss is associated with self or a family member sick with COVID-19. Based on data collected from the U.S Research and Development Survey (RANDS), this research projects the relationship between on-the-job possibility and age of the index group and calculates the employment possibilities of the index group relative to the healthy group, namely the employment ratio. The weekly loss of productivity, presented by earnings, associated with COVID-19 for groups aged 18-44 years and 45-64 years was calculated, since the 18- to 64-year-old population is an economy's active workforce. Analytical results indicate that the older the age group, the lower the on-the-job possibility, and the higher the weekly productivity loss due to self or a family member being sick from COVID-19. For the group aged 45-64 years, the employment ratio of the index group relative to the healthy group dropped from 0.863 to 0.39, corresponding to a weekly productivity loss of 136-590 US dollars. The overall impact would be about a 9% loss in GDP. Infected or quarantined people would be confined to working in relatively isolated offices or places to allow for social distancing. Proactive health promotion in the workplace plus reactive work through telecommunication systems would reduce such losses. Such preparedness needs to be implemented early for more vulnerable workers who are of middle or old age and/or those comorbid with diabetes.
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Affiliation(s)
- Fuhmei Wang
- Department of Economics, College of Social Science, National Cheng Kung University, Tainan 701, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Occupational and Environmental Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan 704, Taiwan
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Dabbagh A, Seens H, Fraser J, MacDermid JC. What Are Work-Related Predictors of Post-COVID-19 Home and Family Work Roles? A Cross-Sectional Survey. J Occup Environ Med 2022; 64:19-25. [PMID: 34982071 PMCID: PMC8715927 DOI: 10.1097/jom.0000000000002406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To determine the extent to which pre-and post-COVID-19 work-related factors can explain post-COVID-19 home and family work roles. METHODS This study was a cross-sectional survey. The primary outcome measure was the Home and Family Work Roles Questionnaire. Descriptive statistical methods and multiple regression analyses were run. The significant predictors were further probed in a one-way analysis of covariance (ANCOVA) model with a Tukey posthoc correction. RESULTS In our sample of 1447 participants, the two significant predictors of post-COVID-19 home and family work roles were pre-pandemic paid job status (F [3, 1401] = 5.66, P < 0.001), and pre-COVID-19 home and family work roles (F [1, 1401] = 2509.26, P < 0.001). CONCLUSION Greater pre-pandemic home and family role responsibilities, full-time and part-time employment pre-COVID-19 were associated with greater post-COVID-19 home and family responsibilities.
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Affiliation(s)
- Armaghan Dabbagh
- Department of Physical Therapy (Ms Dabbagh, Mr Fraser, Dr MacDermid); Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute (Ms Dabbagh, Dr MacDermid); Health and Rehabilitation Sciences Department (Ms Seens), Faculty of Health Sciences, Western University; Windsor University School of Medicine, Cayon, St. Kitts (Ms Seens); Department of Computer Science, University of Guelph, Guelph (Mr Fraser); Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care London (Dr MacDermid), London, Ontario, Canada
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Pak A, Adegboye OA, McBryde ES. Are We Better-Off? The Benefits and Costs of Australian COVID-19 Lockdown. Front Public Health 2021; 9:798478. [PMID: 34926400 PMCID: PMC8674450 DOI: 10.3389/fpubh.2021.798478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/12/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Anton Pak
- Centre for the Business and Economics of Health, The University of Queensland, Brisbane, QLD, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
| | - Oyelola A Adegboye
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia.,Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Emma S McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
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Rathod S, Pallikadavath S, Graves E, Rahman MM, Brooks A, Soomro MG, Rathod P, Phiri P. Impact of lockdown relaxation and implementation of the face-covering policy on mental health: A United Kingdom COVID-19 study. World J Psychiatry 2021; 11:1346-1365. [PMID: 35070782 PMCID: PMC8717029 DOI: 10.5498/wjp.v11.i12.1346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/04/2021] [Accepted: 10/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pandemic mitigation policies, such as lockdown, are known to impact on mental health of individuals. Compulsory face covering under relaxed lockdown restrictions gives assurance of less transmission of airborne infection and has the potential to improve mental health of individuals affected by restrictions. AIM To examine the association of the lockdown relaxation and the implementation of the face covering policy on the mental health of the general population and sub-groups in the United Kingdom using interrupted time series model. METHODS Using a web-based cross-sectional survey of 28890 United Kingdom adults carried out during May 1, 2020 to July 31, 2020, changes in mental health status using generalised anxiety disorder (GAD-7), and impact of events scale-revised (IES-R) scales are examined, at the dates of the first lockdown relaxation (July 4, 2020) and the subsequent introduction of face covering (July 24, 2020) in United Kingdom. A sharp regression discontinuity design is used to check discontinuities in mental health outcomes at policy-change dates. RESULTS Average GAD-7 scores of participants were 5.6, 5.6 and 4.3 during the lockdown period, the lockdown relaxation phase and the phase of compulsory face covering, respectively, with lower scores indicating lower anxiety levels. Corresponding scores for IES-R were 17.3, 16.8 and 13.4, with lower scores indicating less distress. Easing lockdown measures and subsequent introduction of face covering, on average, reduced GAD-7 by 0.513 (95%CI: 0.913-0.112) and 1.148 (95%CI: 1.800-0.496), respectively. Corresponding reductions in IES-R were 2.620 (95%CI: 4.279-0.961) and 3.449 (95%CI: 5.725-1.172). These imply that both lockdown relaxation and compulsory face-covering have a positive association with mental health scores (GAD-7 and IES-R). CONCLUSION The differential impact of lockdown and relaxation on the mental health of population sub-groups is evident in this study with future implications for policy. Introduction of face covering in public places had a stronger positive association with mental health than lockdown relaxation.
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Affiliation(s)
- Shanaya Rathod
- Department of Research and Development, Southern Health NHS Foundation Trust, Southampton SO30 3JB, Hampshire, United Kingdom
- Portsmouth-Brawijaya Centre for Global Health, Population and Policy, University of Portsmouth, Portsmouth PO1 2DT, United Kingdom
| | - Saseendran Pallikadavath
- School of Health and Care Professions, University of Portsmouth, Portsmouth PO1 2DT, Hampshire, United Kingdom
| | - Elizabeth Graves
- Department of Research and Development, Southern Health NHS Foundation Trust, Southampton SO30 3JB, Hampshire, United Kingdom
| | - Mohammad Mahbubur Rahman
- School of Health and Care Professions, University of Portsmouth, Portsmouth PO1 2DT, Hampshire, United Kingdom
| | - Ashlea Brooks
- Department of Research and Development, Southern Health NHS Foundation Trust, Southampton SO30 3JB, Hampshire, United Kingdom
| | - Mustafa G Soomro
- Mental Health, Solent NHS Trust, Portsmouth P03 6AD, United Kingdom
| | - Pranay Rathod
- PPI, PPI Representative, London SO30 3JB, United Kingdom
| | - Peter Phiri
- Department of Research and Development, Southern Health NHS Foundation Trust, Southampton SO30 3JB, Hampshire, United Kingdom
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton SO16 5ST, United Kingdom
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Vandepitte S, Alleman T, Nopens I, Baetens J, Coenen S, De Smedt D. Cost-Effectiveness of COVID-19 Policy Measures: A Systematic Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1551-1569. [PMID: 34711355 PMCID: PMC8481648 DOI: 10.1016/j.jval.2021.05.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/07/2021] [Accepted: 05/23/2021] [Indexed: 05/28/2023]
Abstract
OBJECTIVES The COVID-19 pandemic has had a major impact on our society, with drastic policy restrictions being implemented to contain the spread of the severe acute respiratory syndrome coronavirus 2. This study aimed to provide an overview of the available evidence on the cost-effectiveness of various coronavirus disease 2019 policy measures. METHODS A systematic literature search was conducted in PubMed, Embase, and Web of Science. Health economic evaluations considering both costs and outcomes were included. Their quality was comprehensively assessed using the Consensus Health Economic Criteria checklist. Next, the quality of the epidemiological models was evaluated. RESULTS A total of 3688 articles were identified (March 2021), of which 23 were included. The studies were heterogeneous with regard to methodological quality, contextual factors, strategies' content, adopted perspective, applied models, and outcomes used. Overall, testing/screening, social distancing, personal protective equipment, quarantine/isolation, and hygienic measures were found to be cost-effective. Furthermore, the most optimal choice and combination of strategies depended on the reproduction number and context. With a rising reproduction number, extending the testing strategy and early implementation of combined multiple restriction measures are most efficient. CONCLUSIONS The quality assessment highlighted numerous flaws and limitations in the study approaches; hence, their results should be interpreted with caution because the specific context (country, target group, etc) is a key driver for cost-effectiveness. Finally, including a societal perspective in future evaluations is key because this pandemic has an indirect impact on the onset and treatment of other conditions and on our global economy.
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Affiliation(s)
- Sophie Vandepitte
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Tijs Alleman
- BIOMATH, Department of Data Analysis and Mathematical Modeling, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Ingmar Nopens
- BIOMATH, Department of Data Analysis and Mathematical Modeling, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Jan Baetens
- KERMIT, Department of Data Analysis and Mathematical Modeling, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Samuel Coenen
- ELIZA, Centre for General Practice, Department of Primary and Interdisciplinary Care and VAXINFECTIO, Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Delphine De Smedt
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Iwamoto Y. Welfare economics of managing an epidemic: an exposition. JAPANESE ECONOMIC REVIEW (OXFORD, ENGLAND) 2021; 72:537-579. [PMID: 34690522 PMCID: PMC8521080 DOI: 10.1007/s42973-021-00096-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/12/2021] [Accepted: 08/14/2021] [Indexed: 06/13/2023]
Abstract
This paper reviews recent findings on the normative analysis of private and governmental countermeasures against infectious diseases, focusing on COVID-19. Based on a model that relates the economic activity to infectious disease epidemics, policies that maximize social welfare are considered. Lockdowns in many countries are measures that restrict economic activity over a wide area, and the economic damage they cause is extremely large. Existing studies on the net benefit of lockdown implemented in 2020 have reached mixed conclusions as to whether it is warranted or not. Although the estimates of costs and effects are relatively stable, the setting of the value of a statistical life for converting effects into benefits has a wide range and is also likely to overestimate benefits. Therefore, a careful procedure for setting is particularly crucial to obtain a reliable evaluation of countermeasures. Compared to uniform restriction of activities, taking measures to restrict activities by selecting targets may improve efficiency. Attributes that can be used to select targets include those that can be identified at little or no cost, such as age and industry, and those that can only be identified at a cost, such as close contact with infectious individuals and the presence of pathogens. In comparison to lockdown, these measures may reduce human suffering and economic suffering. No trade-off exists between uniform activity restrictions and selective activity restrictions.
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Affiliation(s)
- Yasushi Iwamoto
- Graduate School of Economics, University of Tokyo, Tokyo, Japan
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Maes C, Vandenbosch L. Physically distant, virtually close: Adolescents' sexting behaviors during a strict lockdown period of the COVID-19 pandemic. COMPUTERS IN HUMAN BEHAVIOR 2021; 126:107033. [PMID: 34608353 PMCID: PMC8481129 DOI: 10.1016/j.chb.2021.107033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 12/28/2022]
Abstract
This study contextualizes Belgian adolescents' (12-18 years old) sexting behaviors between romantic and non-romantic partners during a strict lockdown period of the COVID-19 pandemic. An online survey among 543 Belgian respondents (M age = 15.29, 68% girls) showed that 40.9% of the adolescents engaged in at least one type of sexting (i.e., type one = textual, type two = visual content with underwear/swimwear, type three = visual depiction of private parts, type four = visual depiction of sexual acts). Arousal needs were the most common reasons to sext (M = 3.33, SD = 1.89). Generalized ordered logit analyses show that higher arousal needs were linked to higher frequencies of the first three sexting types. Relational affirmation needs were related to the engagement in sexting type two, whereas partner pressure was related to sexting type three and four. Regarding the latter, a significant link was also found with stress regulation. Conditional relations emerged according to adolescents' sex, developmental status, and relationship status. The current study's findings not only help to inform practitioners in terms of behavioral advice for future pandemics or periods after social isolation, but can also offer explanations for (changes in) adolescents' sexting behaviors after the pandemic and the possible dual nature of its effects.
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Affiliation(s)
- Chelly Maes
- School for Mass Communication Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
| | - Laura Vandenbosch
- School for Mass Communication Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
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Shimul SN, Alradie-Mohamed A, Kabir R, Al-Mohaimeed A, Mahmud I. Effect of easing lockdown and restriction measures on COVID-19 epidemic projection: A case study of Saudi Arabia. PLoS One 2021; 16:e0256958. [PMID: 34499681 PMCID: PMC8428777 DOI: 10.1371/journal.pone.0256958] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 08/19/2021] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES In this study we compared two predictions of COVID-19 cases in the Kingdom Saudi Arabia (KSA) using pre-and post-relaxation of lockdown period data to provide an insight regarding rational exit strategies. We also applied these projections to understand economic costs versus health benefit of lockdown measures. METHODS We analyzed open access data on COVID-19 cases from March 6 to January 16, 2021 in the KSA. To understand the epidemic projection during the pre- and post-lockdown period, we used two types of modeling: the SIR model, and the time series model. We also estimated the costs and benefits of lockdown- QALY gained compared to the costs of lockdown considering the payment threshold of the Government. RESULTS Prediction using lockdown period data suggested that the epidemic might slow down significantly after 109 thousand cases and end on October 6, 2020. However, analysis with latest data after easing lockdown measures suggested that epidemic might be close to an end on October 28, 2021 with 358 thousand cases. The peak has also been shifted from May 18, 2020 to Jun 24, 2020. While earlier model predicted a steady growth in mid-June, the revised model with latest data predicted it in mid-August. In addition, we estimated that 4986 lives would have been saved if lockdown continued but the cost per life saved would be more than $378 thousand, which is way above not only the KSA threshold, but also the threshold of any other highly advanced economies such as the UK and the USA. CONCLUSIONS Our results suggest that relaxation of lockdown measures negatively impacts the epidemic. However, considering the negative impact of prolong lockdown measures on health and economy, countries must decide on the best timing and strategy to exit from such measures to safely return to normal life with minimum loss of lives and economy considering its economic and health systems' capacity. Instead of focusing only on health, a balanced approach taking economy under consideration is recommended.
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Affiliation(s)
| | | | - Russell Kabir
- School of Allied Health, Anglia Ruskin University, Essex, United Kingdom
| | - Abdulrahman Al-Mohaimeed
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Ilias Mahmud
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al Bukairiyah, Buraydah, Saudi Arabia
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Nam NH, Tien PTM, Truong LV, El-Ramly TA, Anh PG, Hien NT, Mahmoud EM, Eltaras MM, Khader SAE, Desokey MS, Gayed RM, Alhady STM, Le BTD, Nguyen DPN, Tiwari R, Eldoadoa M, Howard B, Trung TT, Huy NT. Early centralized isolation strategy for all confirmed cases of COVID-19 remains a core intervention to disrupt the pandemic spreading significantly. PLoS One 2021; 16:e0254012. [PMID: 34264966 PMCID: PMC8282022 DOI: 10.1371/journal.pone.0254012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 06/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background In response to the spread of the coronavirus disease 2019 (COVID-19), plenty of control measures were proposed. To assess the impact of current control measures on the number of new case indices 14 countries with the highest confirmed cases, highest mortality rate, and having a close relationship with the outbreak’s origin; were selected and analyzed. Methods In the study, we analyzed the impact of five control measures, including centralized isolation of all confirmed cases, closure of schools, closure of public areas, closure of cities, and closure of borders of the 14 targeted countries according to their timing; by comparing its absolute effect average, its absolute effect cumulative, and its relative effect average. Results Our analysis determined that early centralized isolation of all confirmed cases was represented as a core intervention in significantly disrupting the pandemic’s spread. This strategy helped in successfully controlling the early stage of the outbreak when the total number of cases were under 100, without the requirement of the closure of cities and public areas, which would impose a negative impact on the society and its economy. However, when the number of cases increased with the apparition of new clusters, coordination between centralized isolation and non-pharmaceutical interventions facilitated control of the crisis efficiently. Conclusion Early centralized isolation of all confirmed cases should be implemented at the time of the first detected infectious case.
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Affiliation(s)
- Nguyen Hai Nam
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Harvard Medical School, Global Clinical Scholars Research Training Program, Boston, Massachusetts, United States of America
- Online Research Club, Nagasaki, Japan
| | - Phan Thi My Tien
- Online Research Club, Nagasaki, Japan
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Le Van Truong
- Online Research Club, Nagasaki, Japan
- Traditional Medicine Hospital of Ministry of Public Security, Hanoi, Vietnam
| | - Toka Aziz El-Ramly
- Online Research Club, Nagasaki, Japan
- Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Pham Gia Anh
- Online Research Club, Nagasaki, Japan
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Thi Hien
- Online Research Club, Nagasaki, Japan
- Emergency Department, Hue City hospital, Hue City, Vietnam
| | - El Marabea Mahmoud
- Online Research Club, Nagasaki, Japan
- Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Sarah Abd Elaziz Khader
- Online Research Club, Nagasaki, Japan
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohammed Salah Desokey
- Online Research Club, Nagasaki, Japan
- Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Ramy Magdy Gayed
- Online Research Club, Nagasaki, Japan
- Faculty of Medicine, Cairo university, Cairo, Egypt
| | | | - Bao-Tran Do Le
- Online Research Club, Nagasaki, Japan
- University of California, Los Angeles, Los Angeles, California, United States of America
| | - Do Phuc Nhu Nguyen
- Online Research Club, Nagasaki, Japan
- Epidemiology Department, Institute of Public Health Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ranjit Tiwari
- Online Research Club, Nagasaki, Japan
- Faculty of Medicine, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Mohammed Eldoadoa
- Online Research Club, Nagasaki, Japan
- Milton Keynes University Hospital, Milton Keynes, United Kingdom
| | - Britney Howard
- Online Research Club, Nagasaki, Japan
- American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten
| | | | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- * E-mail:
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Sonuga-Barke EJS. Editorial: 'No pain - No gain' - Towards the inclusion of mental health costs in balanced "lockdown" decision-making during health pandemics. J Child Psychol Psychiatry 2021; 62:801-804. [PMID: 33961294 DOI: 10.1111/jcpp.13435] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 11/29/2022]
Abstract
Since the beginning of the COVID-19 pandemic in early 2020, many governments have implemented national or regional lockdowns to slow the spread of infection. The widely anticipated negative impact these interventions would have on families, including on their mental health, were not included in decision models. The purpose of this editorial is, therefore, to stimulate debate by considering some of the barriers that have stopped governments setting the benefits of lockdown against, in particular, mental health costs during this process and so to make possible a more balanced approach going forward. First, evidence that lockdown causes mental health problems needs to be stronger. Natural experimental studies will play an essential role in providing such evidence. Second, innovative health economic approaches that allow the costs and benefits of lockdown to be compared directly are required. Third, we need to develop public health information strategies that allow more nuanced and complex messages that balance lockdown's costs and benefits to be communicated. These steps should be accompanied by a major public consultation/engagement campaign aimed at strengthening the publics' understanding of science and exploring beliefs about how to strike the appropriate balance between costs and benefits in public health intervention decisions.
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Affiliation(s)
- Edmund J S Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Welch SB, Kulasekere DA, Prasad PVV, Moss CB, Murphy RL, Achenbach CJ, Ison MG, Resnick D, Singh L, White J, Issa TZ, Culler K, Boctor MJ, Mason M, Oehmke JF, Faber JMM, Post LA. The Interplay Between Policy and COVID-19 Outbreaks in South Asia: Longitudinal Trend Analysis of Surveillance Data. JMIR Public Health Surveill 2021; 7:e24251. [PMID: 34081593 PMCID: PMC8213065 DOI: 10.2196/24251] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 03/18/2021] [Accepted: 06/03/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND COVID-19 transmission rates in South Asia initially were under control when governments implemented health policies aimed at controlling the pandemic such as quarantines, travel bans, and border, business, and school closures. Governments have since relaxed public health restrictions, which resulted in significant outbreaks, shifting the global epicenter of COVID-19 to India. Ongoing systematic public health surveillance of the COVID-19 pandemic is needed to inform disease prevention policy to re-establish control over the pandemic within South Asia. OBJECTIVE This study aimed to inform public health leaders about the state of the COVID-19 pandemic, how South Asia displays differences within and among countries and other global regions, and where immediate action is needed to control the outbreaks. METHODS We extracted COVID-19 data spanning 62 days from public health registries and calculated traditional and enhanced surveillance metrics. We use an empirical difference equation to measure the daily number of cases in South Asia as a function of the prior number of cases, the level of testing, and weekly shifts in variables with a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. RESULTS Traditional surveillance metrics indicate that South Asian countries have an alarming outbreak, with India leading the region with 310,310 new daily cases in accordance with the 7-day moving average. Enhanced surveillance indicates that while Pakistan and Bangladesh still have a high daily number of new COVID-19 cases (n=4819 and n=3878, respectively), their speed of new infections declined from April 12-25, 2021, from 2.28 to 2.18 and 3.15 to 2.35 daily new infections per 100,000 population, respectively, which suggests that their outbreaks are decreasing and that these countries are headed in the right direction. In contrast, India's speed of new infections per 100,000 population increased by 52% during the same period from 14.79 to 22.49 new cases per day per 100,000 population, which constitutes an increased outbreak. CONCLUSIONS Relaxation of public health restrictions and the spread of novel variants fueled the second wave of the COVID-19 pandemic in South Asia. Public health surveillance indicates that shifts in policy and the spread of new variants correlate with a drastic expansion in the pandemic, requiring immediate action to mitigate the spread of COVID-19. Surveillance is needed to inform leaders whether policies help control the pandemic.
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Affiliation(s)
- Sarah B Welch
- Buehler Center for Health Policy & Economics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | | | - P V Vara Prasad
- Sustainable Intensification Innovation Lab, Department of Crop Ecophysiology, Kansas State University, Manhattan, KS, United States
| | - Charles B Moss
- Food and Resource Economics Department, University of Florida, Gainesville, FL, United States
| | - Robert Leo Murphy
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Chad J Achenbach
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Michael G Ison
- Divison of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Danielle Resnick
- International Food Policy Research Institute, Washington, DC, United States
| | - Lauren Singh
- Buehler Center for Health Policy & Economics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Janine White
- Buehler Center for Health Policy & Economics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Tariq Z Issa
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kasen Culler
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Michael J Boctor
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Maryann Mason
- Buehler Center for Health Policy & Economics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - James Francis Oehmke
- Buehler Center for Health Policy & Economics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | | | - Lori Ann Post
- Buehler Center for Health Policy & Economics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Torre E, Colombo GL, Di Matteo S, Martinotti C, Valentino MC, Rebora A, Cecoli F, Monti E, Galimberti M, Di Bartolo P, Gaggioli G, Bruno GM. Economic Impact of COVID-19 Lockdown on Italian NHS: Focus on Diabetes Mellitus. CLINICOECONOMICS AND OUTCOMES RESEARCH 2021; 13:503-518. [PMID: 34163191 PMCID: PMC8213950 DOI: 10.2147/ceor.s313577] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/19/2021] [Indexed: 01/14/2023] Open
Abstract
Background In Italy, the adoption of a total lockdown has generated almost total suspension of outpatient visits except for emergencies. Even after lockdown, the pandemic fear created additional barriers to access the health services. The aim of our study is to evaluate the economic impact of the lockdown for COVID-19 on public health in Italy, focusing on its effects on diabetic population. Materials and Methods We analyzed the impact of the lockdown on excess mortality and morbidity in the Italian diabetic population during 2020. The analysis was divided into several steps: a quantification of specialist visit reduction, the calculation of excess mortality in the diabetic population, the economic evaluation of the slowdown in the use of innovative diabetic therapies. Furthermore, the impact of the lockdown on the reduction of procedures and follow-up visits in diabetic population was evaluated. The overall impact of the pandemic and lockdown effects on costs and quality of life was then calculated. Results During 2020, a drop of 28% in patient access has been observed. Diabetic patients recorded a twice higher mortality value compared to general population (20.4% vs 10.2%). The analysis of market data revealed a slowdown in consumption of new antidiabetic therapies (−14%, 27% vs 41%). We estimated an expense of €26.6 million for NHS and a loss of 257 utilities in diabetic population due to the missed benefits related to slowdown in innovative antidiabetic drugs use and non-optimal follow-up and control of diabetes complications. In simulation scenarios, we also estimated an overall expenditure ranging from €38.7 to 94.0 million and a loss of 294–836 utilities. Conclusion Diabetic population paid a high tribute to pandemic and lockdown, both in terms of number of deaths and burden of diabetic complications, together with an overall deterioration of quality of life.
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Affiliation(s)
- Enrico Torre
- Endocrinology Diabetology and Metabolic Diseases Unit - ASL3, Genoa, Italy
| | | | - Sergio Di Matteo
- S.A.V.E. Studi Analisi Valutazioni Economiche S.r.l., Health Economics & Outcomes Research, Milan, Italy
| | - Chiara Martinotti
- S.A.V.E. Studi Analisi Valutazioni Economiche S.r.l., Health Economics & Outcomes Research, Milan, Italy
| | - Maria Chiara Valentino
- S.A.V.E. Studi Analisi Valutazioni Economiche S.r.l., Health Economics & Outcomes Research, Milan, Italy
| | - Alberto Rebora
- Endocrinology Diabetology and Metabolic Diseases Unit - ASL3, Genoa, Italy
| | - Francesca Cecoli
- Endocrinology Diabetology and Metabolic Diseases Unit - ASL3, Genoa, Italy
| | - Eleonora Monti
- Endocrinology Diabetology and Metabolic Diseases Unit - ASL3, Genoa, Italy
| | | | - Paolo Di Bartolo
- Diabetes Center of Ravenna, Romagna Diabetes Clinical Network, Romagna Local Health Authority, Ravenna, Italy
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ENT UK coronavirus disease 2019 adult tonsillitis and quinsy guidelines: translating guidance into practice. The Journal of Laryngology & Otology 2021; 135:579-583. [PMID: 33653421 PMCID: PMC8144819 DOI: 10.1017/s0022215121000682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES This study examined the uptake of ENT UK coronavirus disease 2019 adult tonsillitis and quinsy guidelines at our tertiary centre, and assessed perceived barriers to uptake. METHODS A retrospective case series of tonsillitis and quinsy patients was analysed in two arms: before and after the introduction of new ENT UK management guidelines. A survey assessed perceptions and practice differences between ENT and emergency department doctors. RESULTS Each study arm examined 82 patients. Following the introduction of new ENT UK guidelines, ENT clinicians demonstrated significant changes in practice, unlike their emergency department counterparts. Survey results from emergency department doctors highlighted a lack of appreciation of guideline change and identified barriers to guideline uptake. CONCLUSION The introduction of new management guidelines for tonsillitis and quinsy patients during the pandemic resulted in disparate uptake within ENT and emergency department departments at the tertiary centre. Clearer dissemination to all affected clinicians is paramount for future rapidly introduced changes to practice, to ensure clinician safety.
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Vandenberg O, Martiny D, Rochas O, van Belkum A, Kozlakidis Z. Considerations for diagnostic COVID-19 tests. Nat Rev Microbiol 2021; 19:171-183. [PMID: 33057203 PMCID: PMC7556561 DOI: 10.1038/s41579-020-00461-z] [Citation(s) in RCA: 438] [Impact Index Per Article: 146.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 02/07/2023]
Abstract
During the early phase of the coronavirus disease 2019 (COVID-19) pandemic, design, development, validation, verification and implementation of diagnostic tests were actively addressed by a large number of diagnostic test manufacturers. Hundreds of molecular tests and immunoassays were rapidly developed, albeit many still await clinical validation and formal approval. In this Review, we summarize the crucial role of diagnostic tests during the first global wave of COVID-19. We explore the technical and implementation problems encountered during this early phase in the pandemic, and try to define future directions for the progressive and better use of (syndromic) diagnostics during a possible resurgence of COVID-19 in future global waves or regional outbreaks. Continuous global improvement in diagnostic test preparedness is essential for more rapid detection of patients, possibly at the point of care, and for optimized prevention and treatment, in both industrialized countries and low-resource settings.
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Affiliation(s)
- Olivier Vandenberg
- Innovation and Business Development Unit, Laboratoire Hospitalier Universtaire de Bruxelles - Universitair Laboratorium Brussel, Université Libre de Bruxelles, Brussels, Belgium.
- Center for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
- Division of Infection and Immunity, Faculty of Medical Sciences, University College London, London, UK.
| | - Delphine Martiny
- Department of Microbiology, Laboratoire Hospitalier Universtaire de Bruxelles - Universitair Laboratorium Brussel, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier Rochas
- Strategic Intelligence, Corporate Business Development, bioMérieux, Chemin de L'Orme, France
| | - Alex van Belkum
- Open Innovation and Partnerships, bioMérieux, La Balme Les Grottes, France.
| | - Zisis Kozlakidis
- Laboratory Services and Biobank Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
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Faggioni MP, González-Melado FJ, Di Pietro ML. National health system cuts and triage decisions during the COVID-19 pandemic in Italy and Spain: ethical implications. JOURNAL OF MEDICAL ETHICS 2021:medethics-2020-106898. [PMID: 33514638 PMCID: PMC7852063 DOI: 10.1136/medethics-2020-106898] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/03/2021] [Accepted: 01/15/2021] [Indexed: 06/12/2023]
Abstract
In this paper, we analyse the most important documents establishing the criteria for the treatment and exclusion of COVID-19 patients, especially in regard to the giving of respiratory support, in Italy and Spain. These documents reflect a tension that stems from limited healthcare resources which are insufficient to save lives that, under normal conditions, could have been saved, or at least could have received the best possible treatment. First, we analyse the healthcare systems of these two countries before the spread of the virus, both of which have seen decreases in the number of intensive care beds and have been marked by financial cuts during the last ten years. It is a fact that a greater number of people, especially those over 70 years of age, have been left without respiratory support treatment, and therefore, there have been a greater number of deaths. It is also a fact that there has been a higher infection rate among healthcare professionals due to the delay in the management of protective measures and the inability to provide adequate care for those in nursing homes, as recognised by WHO. In the context of this health emergency, healthcare professionals have suffered a real 'moral distress' because, knowing first-hand the causes of the limitation of resources, they have had to put triage protocols into practice. Finally, we set forth a series of concrete ethical proposals with which to face the successive waves of COVID-19 infection, as well as other future pandemics.
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Affiliation(s)
| | | | - Maria Luisa Di Pietro
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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Frank J, Williams AJ. A simple tool for comparing benefits and 'costs' of COVID-19 exit strategies. Public Health 2020; 188:4-7. [PMID: 33039678 PMCID: PMC7831639 DOI: 10.1016/j.puhe.2020.08.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/17/2020] [Accepted: 08/28/2020] [Indexed: 12/23/2022]
Abstract
Background Governments and health policymakers are now looking for strategies to lift the COVID-19 lockdown, while reducing risk to the public. Methods We propose the population attributable risk (PAR) as an established epidemiological tool that could support decision-making through quickly estimating the main benefits and costs of various exit strategies. Results We demonstrate the feasibility of use of PAR using pandemic data, that were publicly available in mid-May 2020 from Scotland and the US, to estimate the proportion of COVID-19 hospital admissions which might be avoided, and the proportion of adverse labour market effects – for various scenarios – based on maintaining the lockdown for those of certain ages with and without comorbidities. Conclusion These calculations could be refined and applied in different countries to inform important COVID-19 policy decisions, using routinely collected data. Many countries have tried to exit COVID-19 lockdown. Typically, trade-offs are required. A simple epidemiological tool -- population attributable risk -- can help quantify these trade-offs. This paper quantifies the proportion of COVID-19 hospitalisations averted, versus the proporition of the labour force locked down, for various combinations of age- and comorbidity-related lockdown exit strategies. We show that both continuing lockdown for all persons over 65, and those with comorbidities over 50, have similar effects on hospitalisations. Other considerations, such as equity and acceptability of these policy options, are therefore critical in these final policy decisions.
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Affiliation(s)
- John Frank
- Usher Institute, University of Edinburgh, UK.
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Cost-benefit of COVID-19 lockdown in the UK. PHARMACOECONOMICS & OUTCOMES NEWS 2020; 860:12. [PMID: 32843836 PMCID: PMC7441139 DOI: 10.1007/s40274-020-7058-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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